Factors associated with lift equipment use during patient lifts and transfers by hospital nurses and nursing care assistants: A prospective observational cohort study

• Published in: International journal of nursing studies 2019-03, Vol.91, p.35-46
• Main Authors: Kucera, Kristen L., Schoenfisch, Ashley L., McIlvaine, Jennifer, Becherer, Lori, James, Tamara, Yeung, Yeu-Li, Avent, Susan, Lipscomb, Hester J.
• Format: Article
• Language: English
• Subjects: Assistants; Availability; Care assistants; Cohort analysis; Confidence intervals; Critical care; Health education; Health promotion; Intermediate care; Lift equipment use; Medical technology; Mobility; Nursing; Nursing care; Observational studies; Patient handling; Patient lifting; Patient safety; Patients; Prospective; Safety measures; Situational factors; Teaching
• ISSN: 0020-7489; 1873-491X
• DOI: 10.1016/j.ijnurstu.2018.11.006

Despite wide availability of patient lift equipment in hospitals to promote worker and patient safety, nursing staff do not consistently use equipment. To determine the influence of factors on the use or non-use of lift equipment during patient lifts/transfers. Prospective observational cohort study. One university teaching hospital and two community hospitals in a large health system in southeastern United States. 77 nurses and nursing care assistants with patient handling duties in critical care, step-down and intermediate care units. Participants recorded information about all patient lifts/transfers during their shifts during a 1 week period per month for three months: type of lift/transfer, equipment use, type of equipment, and presence of 20 factors at the time of the lift/transfer. With the patient lift/transfer as the unit of analysis, the association (risk ratios (RR) and 95% confidence intervals (CI)) between factors and equipment use was examined using multivariate Poisson regression with generalized estimating equations. Seventy-seven participants (465 person-shifts) reported 3246 patient lifts/transfers. Frequent lifts/transfers included bed-to-toilet (21%), toilet-to-bed (18%), bed-to-chair (13%), chair-to-bed (13%), chair-to-toilet (6%), and toilet-to-chair (6%). Equipment was used for 21% of lifts/transfers including powered floor based dependent lift (41%), powered sit-to-stand lift (29%), non-powered sit-to-stand lift (17%), air-assisted lateral transfer device (6%), ceiling lift (3%), and air-assist patient lift (3%). Factors associated with equipment use included: availability of equipment supplies (RR = 9.61 [95%CI: 6.32, 14.63]), staff availability to help with equipment (6.64 [4.36, 10.12]), staff preference to use equipment (3.46 [2.48, 4.83]), equipment required for patient condition (2.38 [1.74, 3.25]), patient inability to help with lift/transfer (2.38 [1.71, 3.31]), equipment located in/by patient room (1.82 [1.08, 3.06]), sling already under patient (1.79 [1.27, 2.51]), and patient size/weight (1.38 [0.98, 1.95]). Lower patient mobility score (3.39 [2.19, 5.26]) and presence of physical or mental impairments (2.00 [1.40, 2.86]) were also associated with lift equipment use. Factors associated with non-use of equipment included: patient/family preference (0.31 [0.12, 0.80]), staff assisting with lift did not want to use equipment 0.34 ([0.17, 0.68]), patient condition (0.48 [0.20, 1.20]), and patient almost fell (0.66 [0.45, 0.97